Physical therapists provide services to restore function, improve mobility, relieve pain, and prevent or limit permanent physical disabilities among those suffering from injuries, disabilities, or disease.
Organized physical therapy began during World War I with 800 reconstruction aides. Today there are more than 80,000 licensed physical therapists in the United States.
Physical therapists treat patients with a variety of health conditions and diseases including accident victims and individuals with disabling conditions such as low back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy.
In an effort to restore, maintain, and promote overall fitness and health, physical therapists examine patients' medical histories, as well as test and measure patients' strength, range of motion, balance, coordination, posture, muscle performance, respiration, and motor function. Physical therapists determine patients' ability to be independent and reintegrate into the community or workplace. Based on a patient's medical history and test results, physical therapists develop treatment plans that describe treatment strategy, purpose, and anticipated outcome.
A physical therapist's treatment often includes exercise for patients who have been immobilized or who lack flexibility, strength, or endurance. As part of the treatment, physical therapists encourage patients to improve flexibility, range of motion, strength, balance, coordination, and endurance. The goal is to improve an individual's function at work and home.
Physical therapists may use electrical stimulation, hot packs, cold compresses, or ultrasound to relieve pain and reduce swelling. They may use traction or deep-tissue massage to relieve pain. Therapists also teach patients to use assistive and adaptive devices including crutches, prostheses, and wheelchairs. They may also show patients how to perform exercises to do at home.
During treatment, physical therapists document the patient's progress, conduct periodic examinations, and modify treatments when necessary. Physical therapists rely on this documentation to track the patient's progress and identify areas requiring more or less attention.
Physical therapist assistants and aides
Employment for physical therapist assistants and aides is expected to increase by at least 36% through the year 2008. As with the future outlook for physical therapists, the demand for physical therapist assistants and aides will continue to rise to keep pace with the increase in the number of individuals with disabilities and the rapidly growing elderly population, many of whom are particularly vulnerable to chronic and debilitating conditions that require therapeutic services. These patients often need additional assistance in their treatment, making the roles of assistants and aides vital. As the large baby-boom generation reaches the prime age for heart attacks and strokes, the demand for cardiac and physical rehabilitation will also increase. In addition, future medical developments should permit an increased percentage of trauma victims to survive, creating an additional demand for therapy services.
In 1998, physical therapist assistants and aides earned a median annual income of $21,870. The lowest 10% earned less than $13,760 while the highest 10% earned more than $39,730 a year. The middle 50% earned between $16,700 and $31,260 a year. In 1997, the median annual income earned by physical therapist assistants and aides working in the industries employing the largest number of physical therapist assistants and aides included hospitals, $21,200; health care practitioners offices, $20,700; and nursing and personal care facilities, $19,200.
Physical therapists practice in hospitals, clinics, and private offices. They may also treat patients in the patient's home or at school.
Most physical therapists work a 40-hour week, which may include some evenings and weekends depending on their patients' schedules. The job can be physically demanding, because therapists often have to stoop, kneel, crouch, lift, or stand for long periods of time. In addition, physical therapists move heavy equipment, lift patients, or help them turn, stand, or walk.
In 1998, approximately 75% of the physical therapists employed in approximately 120,000 jobs worked full time. Approximately 10% of physical therapists held more than one job.
Over two-thirds of physical therapists are employed in either hospitals or physical therapists' offices. Other work settings include home health agencies, outpatient rehabilitation centers, physicians' offices and clinics, and nursing homes. Some physical therapists maintain a private practice and provide services to individual patients or contract to provide services in hospitals, rehabilitation centers, nursing homes, home health agencies, adult day-care programs, or schools. They may be engaged in individual practice or be part of a consulting group. Some physical therapists teach in academic institutions and conduct research.
Education and training
Before they can practice, physical therapists are required to pass a licensure exam after graduating from an accredited physical therapist educational program.
According to the American Physical Therapy Association, in 1999 there were 189 accredited physical therapist programs. Of the accredited programs, 24 offered bachelor's degrees, 157 offered master's degrees, and eight offered doctoral degrees. By 2002, the Commission on Accreditation in Physical Therapy Education will require all physical therapist programs seeking accreditation to offer degrees at the post-baccalaureate level.
Physical therapist programs start with basic science courses such as biology, chemistry, and physics, followed by specialized courses such as biomechanics, neuroanatomy, human growth and development, manifestations of disease, examination techniques, and therapeutic procedures. Besides classroom and laboratory instruction, students receive supervised clinical experience.
Admission to physical therapist education programs is very competitive. Interested students may improve their admission potential by attaining superior grades, especially in science courses. Interested students should take courses such as anatomy, biology, chemistry, social science, mathematics, and physics. Before granting admission, many programs require that the student at least have experience as a volunteer in a hospital or clinic physical therapy department.
Physical therapists need strong interpersonal skills to successfully educate patients about their physical therapy treatments and to interact with the patient's family. Therapists should also be compassionate and posses a desire to help patients.
Physical therapists are expected to remain current in their professional development by participating in continuing education courses and workshops. A number of states require continuing education to maintain licensure.
In 1998, physical therapists earned a median annual income of $56,600. The lowest 10% earned less than $35,700 while the highest 10% earned in excess of $90,870 a year. Those in the middle 50% earned between $44,460 and $77,810 a year. In 1997, physical therapists' median annual earnings in the industries employing the largest number of physical therapists included home health care services, $65,600; nursing and personal care facilities, $60,400; health care practitioner offices, $56,600; physicians' offices and clinics, $55,100; and hospitals, $50,100.
Employment for physical therapists is expected to grow by 21–35% through 2008. For a variety of reasons, the demand for physical therapists should continue to rise. As the baby boom generation ages, the number of individuals with disabilities requiring therapy services should increase, as well as patients who will require cardiac and physical rehabilitation after a heart attack or stroke. In addition, the need for physical therapy will be increased as technological advances save the lives of a larger number of newborns with severe birth defects.
Future medical developments will also increase trauma victims' survival rate, thereby creating additional demand for rehabilitative care. Growth may also result from advances in medical technology which permit treatment of more disabling conditions.
Widespread interest in health promotion may also increase demand for physical therapy services. A growing number of employers are seeking the services of physical therapists to evaluate worksites, develop exercise programs, and teach safe work habits to employees in the hope of reducing injuries.
American Physical Therapy Association. Guide to Physical Therapist Practice, 2nd Edition. American Physical Therapy Association, 2001.
Carr, Janet, and Shepherd, Roberta. Movement Science: Foundations for Physical Therapy in Rehabilitation, 2nd Edition. Aspen Publishers, Inc. 2000.
Krumshansl, Bernice. Opportunities in Physical Therapy Careers. VGM Career Horizons, 1999.
U.S. Department of Labor. Occupational Outlook Handbook 2000-2001 Edition. Bureau of Labor Statistics.
The American Physical Therapy Association, 1111 North Fairfax Street, Alexandria, VA 22314-1488. <http://www.apta.org>.
Bill Asenjo, MS, CRC